Abstract
To establish a rapid and simple fluorescence polarization immunoassay method for determination of norvancomycin serum concentration, we collected 300 serum samples from the patients receiving norvancomycin in the hospitals localized in Shanghai, China. The drug concentrations were measured by the established HPLC method and FPIA with vancomycin kit. A FPIA algorithm for the determination of norvancomycin concentration was established according to the correlation between the FPIA and HPLC results. The methods and algorithm were validated in another 70 clinical samples. HPLC determination showed a good linear correlation within the range of 0.5–100 mg l−1 of norvancomycin concentrations. The method was validated via extraction recovery, intra- and inter-day methodological recovery and stability of norvancomycin in serum. Correlation analysis between the measurements of HPLC and FPIA in 300 serum samples gave the linear regression equation: (concentration by HPLC)=0.760 × (concentration by FPIA)–0.577 (P<0.001, R2=0.982). An algorithm was derived from this correlation for measuring the serum norvancomycin concentrations with FPIA. When it was validated in additional 70 serum samples from patients, ‘FPIA algorithm’ showed good accuracy versus HPLC: ‘FPIA algorithm’=0.93 (HPLC)+0.63, R2=0.962, and 94.3% of the results from FPIA algorithm fell within the range of −20%/+20% of HPLC. This algorithm developed in this study can be easily used for determination of norvancomycin using TDx analyzer with vancomycin kit indirectly. It may also be useful for norvancomycin therapeutic drug monitoring.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Andres, I., Lopez, R., Pou, L., Pinpl, F. & Pascualm, V. Vancomycin monitoring: one or two serum levels? Ther. Drug. Monit. 19, 614–619 (1997).
Karam, C. M., McKinnon, P. S., Neuhauser, M. M. & Rybak, M. J. Outcome assessment of minimizing vancomycin monitoring and dosing adjustments. Pharmacotherapy 19, 257–266 (1999).
Zhang, J. et al. Population pharmacokinetic and pharmacodynamic modeling of norvancomycin. Eur. J. Clin. Microbiol. Infect. Dis. 27, 275–284 (2008).
Darko, W., Medicis, J. J. & Smith, A. Mississippi mud no more: cost-effectiveness of pharmacokinetic dosage adjustment of vancomycin to prevent nephrotoxicity. Pharmacotherapy 23, 643–650 (2003).
Cantu, T. G., Yamanaka-Yuen, N. A. & Leitman, P. S. Serum vancomycin concentrations: reappraisal of their clinical value. Clin. Infect. Dis. 18, 533–543 (1994).
Wilhelm, M. P. & Estes, L. Symposium on antimicrobial agents—part XII. Vancomycin. Mayo Clinic. Proc. 74, 928–935 (1999).
Rybak, M. J. & Boike, S. C. Monitoring vancomycin therapy. Drug Intell. Clin. Pharm. 20, 757–761 (1986).
Farber, B. F. & Moellering, R. C. Jr Retrospective study of the toxicity of preparations of vancomycin from 1974 to 1981. Antimicrob. Agents Chemother. 23, 138–141 (1983).
Mellor, J. A., Kingdom, J., Cafferkey, M. & Keane, C. T. Vancomycin toxicity: a prospective study. J. Antimicrob. Chemother. 15, 773–780 (1985).
Sorrell, T. C. & Collignon, P. J. A prospective study of adverse reactions associated with vancomycin therapy. J. Antimicrob. Chemother. 16, 235–241 (1985).
Cimino, M. A., Rotstein, C., Slaughter, R. L. & Emrich, L. J. Relationship of serum antibiotic concentrations to nephrotoxicity in cancer patients receiving concurrent aminoglycoside and vancomycin therapy. Am. J. Med. 83, 1091–1097 (1987).
Celik, I., Cihangiroglu, M., Ilhan, N., Akpolat, N. & Akbulut, H. H. Protective effects of different antioxidants and amrinone on vancomycin vancomycin-induced nephrotoxicity. Basic Clin. Pharmacol. Toxicol. 97, 325–332 (2005).
Le Moyec, L. et al. Aminoglycoside and glycopeptide renal toxicity in intensive care patients studied by proton magnetic resonance spectroscopy of urine. Crit. Care Med. 30, 1242–1245 (2002).
Nishino, Y. et al. Inhibition of vancomycin-induced nephrotoxicity by targeting superoxide dismutase to renal proximal tubule cells in the rat. Redox. Rep. 7, 317–319 (2002).
Farin, D., Piva, G. A., Gozlan, I. & Kitzes-Cohen, R. A modified HPLC method for the determination of vancomycin in plasma and tissues and comparison to FPIA (TDX). J. Pharm. Biomed. Anal. 18, 367–372 (1998).
Jehl, F., Monteil, H., Gallion, C. & Thierry, R. C. HPLC RIA FPIA. Evaluation of 3 methods for the assay of vancomycin. Pathol. Biol. (Paris) 33 (5 Pt 2), 511–516 (1985).
Jesús Valle, M. J., López, F. G. & Navarro, A.S. Development and validation of an HPLC method for vancomycin and its application to a pharmacokinetic study. J. Pharm. Biomed. Anal. 48, 835–839 (2008).
Najjar, T. A., al-Dhuwailie, A. A. & Tekle, A. Comparison of high-performance liquid chromatography with fluorescence polarization immunoassay for the analysis of vancomycin in patients with chronic renal failure. J. Chromatogr. B Biomed. Appl. 672, 295–299 (1995).
Zhang, J. et al. Clinical pharmacokinetics and therapeutic drug monitoring of norvancomycin. Chinese J. Infect. Chemother. 3, 202–205 (2003).
US Department of Health and Human Services, Food and Drug Administration. Recommendations: Clinical Laboratory Improvement Amendments of 1988 (CLIA) Waiver applications for manufacturers of in vitro diagnostic devices, http://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/GuidanceDocuments/ucm079632.htm (2008).
Acknowledgements
We thank all the subjects who provided their blood samples and the people who offered technology support to this study.
Author information
Authors and Affiliations
Corresponding author
Additional information
Shanghai Leading Academic Discipline Project, Project No. B119.
Rights and permissions
About this article
Cite this article
Wu, XJ., Zhang, J., Yu, JC. et al. Establishment of norvancomycin fluorescence polarization immunoassay for therapeutic drug monitoring. J Antibiot 65, 35–39 (2012). https://doi.org/10.1038/ja.2011.89
Received:
Revised:
Accepted:
Published:
Issue date:
DOI: https://doi.org/10.1038/ja.2011.89
Keywords
This article is cited by
-
A ratiometric fluorescent probe for sensitive determination of the important glycopeptide antibiotic vancomycin
Analytical and Bioanalytical Chemistry (2019)
-
Three structurally-related impurities in norvancomycin drug substance
The Journal of Antibiotics (2017)


